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1063485670
KEVIN WISDOM
FAYETTEVILLE, AR
NPI
1063485670
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: AR PT2490)
Enumeration Date
2006-02-13
Last Update Date
2010-12-14
Business Address
KEVIN WISDOM P.T.
3317 N WIMBERLY DR
FAYETTEVILLE, AR 72703-4056
Phone number: 479-521-2752
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Mailing Address
KEVIN WISDOM P.T.
PO BOX 1608
FAYETTEVILLE, AR 72702-1608
Phone number: 479-521-2752
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